Which drug is a common choice for treating VRE infections and has activity against MRSA as well?

• A. Linezolid
• B. Vancomycin
• C. Tigecycline
• D. Daptomycin

Answer: (A)

Linezolid is the best pick because it reliably covers vancomycin-resistant Enterococcus (VRE) and also has activity against MRSA. It belongs to the oxazolidinone class and works by binding the 50S ribosomal subunit to block initiation of protein synthesis, making it effective against these resistant gram-positive organisms. Its excellent oral bioavailability also allows seamless IV-to-oral therapy, which is a practical advantage for treating invasive VRE infections.

Vancomycin won’t work against VRE, since these strains are resistant to it. Tigecycline does cover MRSA and VRE, but its low serum concentrations limit usefulness for bloodstream infections. Daptomycin can treat MRSA and some VRE, but resistance can occur and it isn’t suitable for pneumonia, so it isn’t as consistently reliable as linezolid for VRE infections with MRSA overlap.